Renin-angiotensin system block and atrial fibrillation

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Updated: Aug 12, 2026

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
28:13

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

Published on: February 26, 2013

Federico Lombardi1, Paolo Terranova

  • 1Cardiologia, Dipartimento di Medicina, Chirurgia e Odontoiatria, Osp. San Paolo, University of Milan, 20142 Milan, Italy. Federico.Lombard@unimi.it

Current Medicinal Chemistry
|June 25, 2005
PubMed

Insights

Atrial fibrillation treatment is challenging due to cardiac remodelling. Targeting the Renin-Angiotensin-Aldosterone System with ACE inhibitors and AT(1) receptor blockers shows promise in managing this common arrhythmia.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Pharmacology

Background:

  • Atrial fibrillation is the most prevalent cardiac rhythm disorder, notoriously difficult to treat.
  • Cardiac remodelling, encompassing electrical, mechanical, and anatomical changes, complicates rhythm restoration.
  • Atrial fibrosis, a key remodelling component, is significantly influenced by the Renin-Angiotensin-Aldosterone System.

Purpose of the Study:

  • To investigate the role of the Renin-Angiotensin-Aldosterone System in atrial fibrillation.
  • To evaluate the anti-arrhythmic effects of ACE inhibitors and AT(1) receptor blockers.
  • To assess the efficacy of AT(1) receptor blockers in combination with amiodarone for atrial fibrillation recurrence.

Main Methods:

  • Review of experimental and clinical data on the Renin-Angiotensin-Aldosterone System in atrial fibrillation.
  • Analysis of studies on ACE inhibitors and AT(1) receptor blockers as anti-arrhythmic agents.
  • Evaluation of clinical trials examining the adjunction of AT(1) receptor blockers to amiodarone.

Main Results:

  • The Renin-Angiotensin-Aldosterone System plays a pro-arrhythmic role in atrial fibrillation.
  • ACE inhibitors and AT(1) receptor blockers demonstrate anti-arrhythmic effects.
  • Combining AT(1) receptor blockers with amiodarone improved outcomes compared to amiodarone alone in reducing arrhythmia recurrence post-cardioversion.

Conclusions:

  • Pharmacological interventions targeting electrical and structural remodelling are crucial for managing atrial fibrillation.
  • ACE inhibitors and AT(1) receptor blockers offer effective therapeutic options to prevent the progression of atrial fibrillation to permanent forms.

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